Patient couch



y 1958 s.-A. B. HANSEN EI'AL 2,845,543

PATIENT coucn Filed Jan. 7, 1955 INVENTORS SVEND A. B. HANSEN 8. VERNER CHRISTENSEN United States atent O" PATIENT COUCH Svend Aage Bruun Hansen, Copenhagen, and Verner Christensen, Thisted, Denmark Application January 7, 1955, Serial N 0. 480,516 Claims priority, application Denmark January .9, 1954 7 Claims. (Cl. 250-54) The invention relates to a patient couch or couch equipment, particularly for use at examinations, X-ray photography, or treatment, and with at least two parts which are movable in relation to each other.

Operation couches are known in which the couch is divided into two parts hinged together along the rectilinearly extending adjacent edges, so that from a state in which it is plane the couch can be pushed up so as to resemble a gable roof, so that a patient resting on his side on the couch is made to lie with a sideward bend in the hip, by which means an injury around the hip becomes more easily accessible for an operation.

An object of the present invention is to provide a patient couch which is particularly well suited as diagnosis apparatus, X-ray equipment or treatment apparatus in connection with back defects or anomalies. In the case of X-ray photography of the lower part of the back (columna lumbo sacralis) the procedure has hitherto been that the patient is placed in a sitting or half-sitting position so that a pressure is exerted on the individual elements of the spinal column, after which X-ray pictures are taken in part with the patient sitting in an upright position, in part with the patient sitting in inclined positions to the right and to the left. As the body inclinations can often be very painful to the patient, it may be difiicult for the patient to keep immovable, so that. the radiography may become rather lengthy and painful because the pictures have to be re-taken. I

A further object of the invention is to avoid these drawbacks. According to the invention the couch comprises a seat part and a pack part mounted turnably in relation to each other in such a way that the axis, around which the back part is turned in relation to stationary seat part, is substantially at right angles to the patient-supporting surface of the seat-part and is located at a suitable distance from the curved joint between the vtwo parts. By suitable distance is meant a distance permitting ,that the lumbar lordosis of a patient resting on the couch aligns the joint when the axis of rotation passes through the lowest sacral vertebra. By this construction is attained that the patient rests in a substantially horizontal plane so that no pressure is exerted on the vertebrae, and by one of the two parts of the patient couch being swung in relation to the other, e. g. the seat part in relation to the back part, the lumbar part of the patients spinal column can be put in an optional angular position, particularly convenient with a view to diagnostication or photography, in relation to the rest of the spinal column. In other words, the X-ray photographer is not dependent on the patient being in part able himself to take up the desired angular position, in part able to remain in this position as long as the examination or the radiography is being performed.

A still further object of the invention is to provide a patient couch being well suited as treatment couch in cases where a sideward bending of the lumbar part of the patients spinal column is to be performed in relation to 'ice the rest of the spinal column, e.. g. for the purpose of straightening out an existing scoliosis.

Still another object of the invention is a method of treatment carried out by means of the couch.

The invention is in the following explained in detail with reference to the accompanying drawing where:

Fig. 1 illustrates a plan view of an embodiment of a patient couch according to the invention,

Fig. 2 the patient couch shown in Fig. l, in side elevation and in section on line II-II,

Fig. 3 an embodiment of a bearing connecting the two parts of the patientcouch to each other, viewed :from the centre of rotation for the turnable part of the patient couch, and

Fig. 4 a section on line IVIV in Fig. 3.

1 and 2 in Figs. 1 and 2 designate the two parts of the patient couch, which two parts are movable in relation to each other. The couch part 1 rests on two pairs of legs 3 and 4, two of which are shown in Fig. 2, while all of the four legs have been indicated in dotted lines in Fig. 1. The legs are so mounted that they are not located within the range where there is a possibility of X-ray pictures being taken. The part 1 of the patient couch need not have the shape shown in Fig. l, as it may for example be shortened for the purpose of coupling it to existing tables :or to a temporary couch of cushions for the purpose of putting the patient into a sitting or half-sitting position. The part 1 of the patient couch is, however, couveniently made so large as to extend all the way to the upper end of culumna lumbo sacralis on a patient resting correctly on the patient couch.

The part1 of the patient couch carries a supporting member for one end of the part 2 of the patient couch, and in the example shown the supporting 'member is formed by a substantially circular carrying bar 5 which, opposite to the side where it is in fixed connection with the part 1 of the patient couch, is supported by two legs 6 and 7, of which only the leg 6 is shown in Fig. 2

In Fig. 4, which shows an embodiment of the connection btween the two parts 1 and 2 of the patient couch, the circular supporting member 5 is a bar of U-shaped cross-section. The inner surfaces of the flanges of the bar 5 serve as running paths for balls mounted on a supporting member 8 secured to the patient couch. A suitable number of such supporting members may be provided, for example four. It' is, however, also possible to-let such a ball-bearing support extend the whole way round. The balls may also be carried by a ball bearing ring which is in fixed connection with the part 1 of the patient couch, so that the supporting member or each of the supporting members 8 need only carry a bar 9 which will thus run on balls stationary in space when the part 2 of the patient couch is turned in relation to the stationary part 1 of the patient couch. The connection between the two parts 1 and 2 of the patient couch may also'be effected without the use of ball bearings. The essential feature in this connection is not the nature of the bearing, but the mounting of the bearing in relation to the patient couch, so that the bearings do not get within the field of exposure, i. e. the area around the longitudinal axis of the patient couch, especially the area around the centre for the rotary motion. The bearing need not per se bearranged for carrying anything, but serves first and foremost for ensuring that the connection between the two parts of the patient couch is maintained during their motion in relation to each other. The principle requires no' connection at all between the two parts of'the patient couch, it being possible to perform adjustment and alignment manually.

The part 2 of the patient couch, which part is in the embodiment example shown on the drawing at one'end supported by a supporting member 8 resting-on the bearing 5, is at the other end supported by a leg arranged for being easily displaced along the supporting surface, for example by being provided with a wheel 11. More legs than those shown on the drawing may be provided.

The field, within which X-ray photographs will most frequently be taken, is that designated by a in Fig. 2, and within this range lies the joint between the parts 1 and 2 of the patient couch. This joint should be of such a nature that it will not show on the X-ray picture. This means that a ray at right angles to the contact surface of the patient couch should cover the shortest possible distance in the joint space which should therefore have a form differing from the cylindrical form, where the generatrix is at right angles to the contact surface of the patient couch.

The joint is in the case shown designed as part of a conical surface, the two surfaces facing each other on the parts 1 and 2 of the patient couch being surfaces on cones, the apexes of which lie under the part 2 of the patient couch. It is possible to choose conical surfaces, the apexes of which lie above the patient couch, and it is also possible to use a stepped form so that the two surfaces facing each other have the same form as the surfaces on stepped pulleys. In the joint as well as in all other places within the picture frame no metal bars or other materials must be used with atomic weights different from the material of the parts of the patient couch, as this might cause undesirable maks to show on the X-ray picture.

For the purpose of adjusting the joint, adjustment devices, not shown, may be provided for adjusting the level of the two parts 1 and 2 of the patient couch in relation to each other. If the two parts of the patient couch are only placed together without any direct interconnection, it is for example possible to use legs that are height-adjustable in a way known per se.

When the patient couch is to be used, the patient is placed resting for example on his back with his back against the back part 1 and his head to the right in Figs. 1 and 2, and with his lowest sacral vertebra in the centre 0 for the turning motion of the part2 of the patient couch. The centre 0 may with a view to the proper placing of the patient be marked on the upper side of the part 2 of the patient couch. The patients legs rest on the part 2 of the patient couch. An X-ray picture is taken with the two parts of the patient couch in alignment. Without the patient being moved or contributing himself to the turning, the part 2 of the patient couch is then turned an angle, e. g. clockwise, in relation to the part 1 of the patient couch. The size of the angle can be read on an angle scale, not shown, and depends on the side curvature with which it be desired to take the picture. Another X-ray picture is taken, whereupon the part 2 of the patient couch is turned an angle desired to the opposite side, i. e. anticlockwise in relation to the part 1 of the patient couch, with the patient still resting on his back on the two parts of the couch, and then a third X-ray picture is taken.

The patient couch may also be used for taking X-ray pictures of patients lying on their sides. In this case the part 2 of the patient couch may be arranged for being lowered in relation to the part 1 of the patient couch, so that a sideward obliquity of the spinal column is avoided when the patient lies on his side, The extent of the two parts of the couch may in the embodiment given be adapted to the range of application aimed at. The surface of the couch need not be plane, for instance it can have a urface in the form of the body.

When treating a patient he or she may be brought in fixed position in relation to both parts of the couch for example by means of straps or the like. During the treatment one part is kept stationary and the other oscillated through the angle prescribed by doctor. The oscillation may be carried out by hand or by any other known means, for instance an electric motor.

The patient couch according to the invention is, particularly when it is to be used as X-ray equipment, so de signed that the parts of the couch, which by a motion of the seat part in relation to the back part can be brought within the picture frame, have uniform transmission factors for the X-rays, so that no undesirable shadows or light areas show on the picture. The joint between the two parts, back part and seat part, might cause such a shadow or light area, but according to the invention the joining faces are expediently parts of a conical surface, the axis of rotation of which coincides with the axis of rotation of the seat part. Hereby is attained that X-rays emitted at right angles to the contact surface of the patient couch are everywhere subjected to the same absorption.

The patient couch according to the invention may form part of the equipment for an X-ray apparatus, but need not in itself be a complete couch, it being possible to couple it to an existing table, the latter then representing the remaining part of the patient couch.

The two parts may be supported separately and only guided in their motion in relation to each other, or one part may completely or partly support the other. In the case of X-ray apparatuses, care must be taken that the bearings, if any, do not lie within the bounds of the picture frame so as to show on the picture.

Treatments according to the invention camprises treatment of a unilateral protrusion of an intervertebral disc. Further it comprises the case in which not an active but only a passive external force is present, for instance one or two springs trying to keep two parts of the couch in a preset position, preferably in alignment, from which position it is up to the patient to move the two parts against the spring force thereby training the muscles and actuating the spinal column. When relaxing the said two parts of the couch and consequently the patient is brought back to the original position. The couch may be divided in several parts and springs can be arranged between every two adjacent parts or only between a single pair or some of the pairs. By an increasing number of parts the couch is tending to be a reproduction of the spinal column.

We claim:

1. In a patient couch for use in X-ray examinations and treatment and comprising at least two co-planar parts, a seat part and a back part rotatable in relation to each other in a single plane, that improvement comprising a joint between the two parts having a shape such that X-rays striking the joint at substantially right angles to the plane of the surface of the parts of said couch penetrate the same thickness of material as X-rays striking any other point of the parts of said couch within the field of exposure at substantially right angles.

2. The improvement as claimed in claim 1, said joint being formed by two complementary abutting surfaces, one being the outer surface of a truncated cone and the other being the inner surface of a truncated cone, the axis of both cones coinciding with the axis of rotation of the seat part.

3. A patient couch for use in X-ray examinations and treatment comprising a seat part and a back part which are co-planar and rotatable in relation to each other in a single plane, a joint between the seat part and the back part having a shape such that X-rays striking the joint at a substantially right angles to the plane of the surface of the parts of said couch penetrate the same thickness of material as X-rays striking any other point of the parts of said couch within the field of exposure at substantially right angles, the materials of which the parts of said couch which lie within said field of exposure are composed having the same coefficient of penetration for X-rays.

4. A patient couch as claimed in claim 3, said joint being formed by two complementary abutting surfaces,

one being the outer surface of a truncated cone and the other being the inner surface of a truncated cone, the axis of both cones coinciding with the axis of rotation of the seat part.

5. A patient couch for use in X-ray examinations and treatment, comprising at least two co-planar parts, a

seat part and a back part, rotatable in relation to each other in a single plane, and having a circular joint between the two parts, the material and the shape of the two parts adjacent to the joint being such that an image of the joint does not appear on a picture produced by the passage of X-rays through said parts.

6. A patient couch as claimed in claim 5, and an angle scale being provided in fixed connection with one of said parts and an indicator cooperable with said angle scale provided in fixed connection with the other part.

7. A patient couch for use in X-ray examinations and treatment comprising a seat part and a back part which are co-planar and rotatable in relation to each other in a single plane, a circular joint between the two parts, the material and shape of the two parts adjacent the joint being such that an image of the joint does not appear on a picture produced by the passage of X-rays through said parts, said back part having a carrying member shaped as an arc of a circle, the ends of said carrying member being connected to said back part outside the field of exposure, two legs positioned outside the field of exposure supporting said carrying member at a distance from the back part, the seat part comprising a supporting member at one end coacting with said carrying member and two legs with rollers on their lower ends at the other end.

References Cited in the file of this patent UNITED STATES PATENTS 921,559 McManis May 11, 1909 1,092,435 Dorrance Apr. 7, 1914 1,213,137 Albright Jan. 23, 1917 1,600,598 Meyer Sept. 21, 1926 

